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Vücut Kitle İndeksi ile Kardiyak Elektrofizyolojik Denge İndeksi Arasındaki İlişki

Yıl 2024, Cilt: 21 Sayı: 3, 375 - 381
https://doi.org/10.35440/hutfd.1467230

Öz

Amaç: Obezite ile elektrokardiyografik dalga sürelerindeki değişiklikler arasındaki ilişki daha önce gösterilmiştir. Vücut kitle indeksi (BMI) ile kardiyak elektrofizyolojik denge indeksi (ICEB)/düzeltilmiş kardiyak elektrofizyolojik denge indeksi (ICEBc) arasındaki ilişkiyi incelemeyi planladık.
Materyal ve metod: Eylül-Kasım 2023 tarihleri arasında obezite dışında ek hastalığı olmayan toplam 353 kişi (199 kadın, 154 erkek, ortalama yaş 32,6 ± 10,611 yıl) çalışmaya dahil edildi. Tüm hastalar BMI'a göre 5 gruba ayrıldı. BMI<20 kg/m2 olan katılımcılar grup 1 olarak tanımlandı, BMI=20-24,99 kg/m2; grup 2, BMI=25-29,99 kg/m2; grup 3, BMI=30-39,99 kg/m2; grup 4 ve son olarak BMI>40 kg/m2 ise grup 5 olarak tanımlandı.
Bulgular: Yaş ortalaması 32,6±10,61 olup toplam kadın katılımcı sayısı 199 (%56,4) idi. Grupların ortalama BKİ'si sırasıyla 18,72±1,25, 22,84±1,48, 26,86±1,36, 34,65±3,24, 44,63±4,11 (p<0,001) idi. Grupların ortalama ICEB'si 4,36±0,53, 4,17±0,53, 4,04±0,52, 4,27±0,55, 4,18±0,47 (p=0,014), ICEBc ise 5,03±0,69, 4,81±0,63, 4,6±0,56, 5,05±0,68, Sırasıyla 5,05±0,52 (p<0,001). BMI ile QTc intervali, ICEB ve ICEBc'de anlamlı artış gözlenirken, QT intervalinde anlamlı bir değişiklik gözlenmedi.
Sonuç: Çalışmamız obezitenin aynı zamanda ICEB ve ICEBc değerlerinde de anlamlı artışa neden olduğunu gösterdi. Çalışmamız ışığında ICEB ve ICEBc değerlerinin obez bireylerde kötü kardiyak sonuçların öngörücüsü olabileceği gösterilmiştir.

Destekleyen Kurum

Yoktur

Kaynakça

  • 1. Poirier P, Eckel RH. Obesity and cardiovascular disease. Curr Atheroscler Rep. 2002;4(6):448-53.
  • 2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalen-ce of overweight and obesity in children and adults du-ring 1980-2013: a systematic analysis for the Global Bur-den of Disease Study 2013. Lancet. 2014;384(9945):766-81.
  • 3. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Fra-mingham Heart Study. Circulation. 1983;67(5):968-77.
  • 4. Abel ED, Litwin SE, Sweeney G. Cardiac remodeling in obesity. Physiol Rev. 2008;88(2):389-419.
  • 5. Molinari G, Sardanelli F, Zandrino F, Parodi RC, Bertero G, Richiardi E, et al. Adipose replacement and wall mo-tion abnormalities in right ventricle arrhythmias: evalua-tion by MR imaging. Retrospective evaluation on 124 pa-tients. Int J Card Imaging. 2000;16(2):105-15.
  • 6. Monitillo F, Leone M, Rizzo C, Passantino A, Iacoviello M. Ventricular repolarization measures for arrhythmic risk stratification. World J Cardiol. 2016;8(1):57-73.
  • 7. Lu HR, Yan GX, Gallacher DJ. A new biomarker--index of cardiac electrophysiological balance (iCEB)--plays an im-portant role in drug-induced cardiac arrhythmias: beyond QT-prolongation and Torsades de Pointes (TdPs). J Phar-macol Toxicol Methods. 2013;68(2):250-9.
  • 8. Lu HR, Yan G-X, Gallacher DJ. A new biomarker – index of Cardiac Electrophysiological Balance (iCEB) – plays an important role in drug-induced cardiac arrhythmias: be-yond QT-prolongation and Torsades de Pointes (TdPs). Journal of Pharmacological and Toxicological Methods. 2013;68(2):250-9.
  • 9. Rakocevic Stojanovic V, Peric S, Paunic T, Pavlovic S, Cvi-tan E, Basta I, et al. Cardiologic predictors of sudden de-ath in patients with myotonic dystrophy type 1. J Clin Ne-urosci. 2013;20(7):1002-6.
  • 10. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Car-diology (AEPC). Eur Heart J. 2015;36(41):2793-867.
  • 11. Tse G, Yan BP. Traditional and novel electrocardiographic conduction and repolarization markers of sudden cardiac death. Europace. 2017;19(5):712-21.
  • 12. Guzelcicek A, Kilinc E, Fedai H, et al. Relationship between Vitamin D Level and Index of Cardio Electrophy-siological Balance in Children. Comb Chem High Thro-ughput Screen. 2023 Aug 16. doi: 10.2174/1386207326666230816094807
  • 13. Sivri S, Çelik M. Evaluation of index of cardiac-electrophysiological balance before and after hemodialy-sis in patients with end-stage renal disease. J Electrocar-diol. 2019;54:72-5.
  • 14. Efe SC, Oz A, Guven S, Kambur I, Topacoglu H, Karabag T. Evaluation of index of cardiac-electrophysiological balan-ce as arrhythmia predictor in bonsai users. Minerva Car-dioangiol. 2020;68(6):559-66.
  • 15. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14.
  • 16. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovas-cular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53(21):1925-32.
  • 17. Esposito K, Nicoletti G, Marzano S, Gualdiero P, Carusone C, Marfella R, et al. Autonomic dysfunction associates with prolongation of QT intervals and blunted night BP in obese women with visceral obesity. J Endocrinol Invest. 2002;25(11):Rc32-5.
  • 18. el-Gamal A, Gallagher D, Nawras A, Gandhi P, Gomez J, Allison DB, et al. Effects of obesity on QT, RR, and QTc intervals. Am J Cardiol. 1995;75(14):956-9.
  • 19. Park JJ, Swan PD. Effect of obesity and regional adiposity on the QTc interval in women. Int J Obes Relat Metab Di-sord. 1997;21(12):1104-10.
  • 20. Corbi GM, Carbone S, Ziccardi P, Giugliano G, Marfella R, Nappo F, et al. FFAs and QT intervals in obese women with visceral adiposity: effects of sustained weight loss over 1 year. J Clin Endocrinol Metab. 2002;87(5):2080-3.
  • 21. Girola A, Enrini R, Garbetta F, Tufano A, Caviezel F. QT dispersion in uncomplicated human obesity. Obes Res. 2001;9(2):71-7.
  • 22. Gryglewska B, Grodzicki T, Czarnecka D, Kawecka-Jaszcz K, Kocemba J. QT dispersion and hypertensive heart dise-ase in the elderly. J Hypertens. 2000;18(4):461-4.
  • 23. Karason K, Wallentin I, Larsson B, Sjöström L. Effects of obesity and weight loss on cardiac function and valvular performance. Obes Res. 1998;6(6):422-9.
  • 24. Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321(4):225-36.
  • 25. Chauhan VS, Krahn AD, Walker BD, Klein GJ, Skanes AC, Yee R. Sex differences in QTc interval and QT dispersion: dynamics during exercise and recovery in healthy sub-jects. Am Heart J. 2002;144(5):858-64.
  • 26. Di Salvo G, Pacileo G, Del Giudice EM, Natale F, Limon-gelli G, Verrengia M, et al. Atrial myocardial deformation properties in obese nonhypertensive children. J Am Soc Echocardiogr. 2008;21(2):151-6.
  • 27. Magnani JW, Lopez FL, Soliman EZ, Maclehose RF, Crow RS, Alonso A. P wave indices, obesity, and the metabolic syndrome: the atherosclerosis risk in communities study. Obesity (Silver Spring). 2012;20(3):666-72.
  • 28. Després JP. Body fat distribution and risk of cardiovascu-lar disease: an update. Circulation. 2012;126(10):1301-13.
  • 29. Robyns T, Lu HR, Gallacher DJ, Garweg C, Ector J, Wil-lems R, et al. Evaluation of Index of Cardio-Electrophysiological Balance (iCEB) as a New Biomarker for the Identification of Patients at Increased Arrhythmic Risk. Ann Noninvasive Electrocardiol. 2016;21(3):294-304.
  • 30. Ortega FB, Lavie CJ, Blair SN. Obesity and Cardiovascular Disease. Circ Res. 2016;118(11):1752-70.

The Relationship Between Body Mass Index And Index of Cardiac Electrophisiological Balance

Yıl 2024, Cilt: 21 Sayı: 3, 375 - 381
https://doi.org/10.35440/hutfd.1467230

Öz

Background: The relationship between obesity and changes in electrocardiographic wave duration were demonstrated previously. The aim of our study was to examine the relationship between body mass index (BMI) and index of cardiac electrophysiological balance (ICEB)/corrected index of cardiac electrophysiological balance (ICEBc).
Materials and Methods: A total of 353 consecutive patients with no comorbidities other than obesity admitted to an outpatient cardiology clinic between September and November 2023 were enrolled in the study. The patients were divided into 5 groups according to their BMI as follows: BMI <20 kg/m2 was defined as group 1, BMI 20–24.99 kg/m2 as group 2, BMI 25–29.99 kg/m2 as group 3, BMI 30–39.99 kg/m2 as group 4 and BMI >40 kg/m2 as group 5. Electrocardiographic parameters ICEB/ICEBc levels were compared among the groups.
Results: The mean age of the participants was 32.6±10.61 years, and 199 (56.4%) were female. The mean ICEB values of groups were 4.36±0.53, 4.17±0.53, 4.04±0.52, 4.27±0.55 and 4.18±0.47, respectively and there was a significant difference among the groups (p=0.014). In addition, the mean ICEBc values were 5.03±0.69, 4.81±0.63, 4.6±0.56, 5.05±0.68, and 5.05±0.52, respectively and there was a significant difference among the groups (p<0.001). It was found that low and high BMI groups were associated with a significant increase in ICEB and ICEBc values in the subgroup analyses.
Conclusions: As a result of our study, it was observed that low and high BMI values may be associated with an increase in ICEB and ICEBc values. It should be kept in mind that ICEB and ICEBc values may be high in cardiac evaluation in relatively thin and obese individuals.

Kaynakça

  • 1. Poirier P, Eckel RH. Obesity and cardiovascular disease. Curr Atheroscler Rep. 2002;4(6):448-53.
  • 2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalen-ce of overweight and obesity in children and adults du-ring 1980-2013: a systematic analysis for the Global Bur-den of Disease Study 2013. Lancet. 2014;384(9945):766-81.
  • 3. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Fra-mingham Heart Study. Circulation. 1983;67(5):968-77.
  • 4. Abel ED, Litwin SE, Sweeney G. Cardiac remodeling in obesity. Physiol Rev. 2008;88(2):389-419.
  • 5. Molinari G, Sardanelli F, Zandrino F, Parodi RC, Bertero G, Richiardi E, et al. Adipose replacement and wall mo-tion abnormalities in right ventricle arrhythmias: evalua-tion by MR imaging. Retrospective evaluation on 124 pa-tients. Int J Card Imaging. 2000;16(2):105-15.
  • 6. Monitillo F, Leone M, Rizzo C, Passantino A, Iacoviello M. Ventricular repolarization measures for arrhythmic risk stratification. World J Cardiol. 2016;8(1):57-73.
  • 7. Lu HR, Yan GX, Gallacher DJ. A new biomarker--index of cardiac electrophysiological balance (iCEB)--plays an im-portant role in drug-induced cardiac arrhythmias: beyond QT-prolongation and Torsades de Pointes (TdPs). J Phar-macol Toxicol Methods. 2013;68(2):250-9.
  • 8. Lu HR, Yan G-X, Gallacher DJ. A new biomarker – index of Cardiac Electrophysiological Balance (iCEB) – plays an important role in drug-induced cardiac arrhythmias: be-yond QT-prolongation and Torsades de Pointes (TdPs). Journal of Pharmacological and Toxicological Methods. 2013;68(2):250-9.
  • 9. Rakocevic Stojanovic V, Peric S, Paunic T, Pavlovic S, Cvi-tan E, Basta I, et al. Cardiologic predictors of sudden de-ath in patients with myotonic dystrophy type 1. J Clin Ne-urosci. 2013;20(7):1002-6.
  • 10. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Car-diology (AEPC). Eur Heart J. 2015;36(41):2793-867.
  • 11. Tse G, Yan BP. Traditional and novel electrocardiographic conduction and repolarization markers of sudden cardiac death. Europace. 2017;19(5):712-21.
  • 12. Guzelcicek A, Kilinc E, Fedai H, et al. Relationship between Vitamin D Level and Index of Cardio Electrophy-siological Balance in Children. Comb Chem High Thro-ughput Screen. 2023 Aug 16. doi: 10.2174/1386207326666230816094807
  • 13. Sivri S, Çelik M. Evaluation of index of cardiac-electrophysiological balance before and after hemodialy-sis in patients with end-stage renal disease. J Electrocar-diol. 2019;54:72-5.
  • 14. Efe SC, Oz A, Guven S, Kambur I, Topacoglu H, Karabag T. Evaluation of index of cardiac-electrophysiological balan-ce as arrhythmia predictor in bonsai users. Minerva Car-dioangiol. 2020;68(6):559-66.
  • 15. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14.
  • 16. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovas-cular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53(21):1925-32.
  • 17. Esposito K, Nicoletti G, Marzano S, Gualdiero P, Carusone C, Marfella R, et al. Autonomic dysfunction associates with prolongation of QT intervals and blunted night BP in obese women with visceral obesity. J Endocrinol Invest. 2002;25(11):Rc32-5.
  • 18. el-Gamal A, Gallagher D, Nawras A, Gandhi P, Gomez J, Allison DB, et al. Effects of obesity on QT, RR, and QTc intervals. Am J Cardiol. 1995;75(14):956-9.
  • 19. Park JJ, Swan PD. Effect of obesity and regional adiposity on the QTc interval in women. Int J Obes Relat Metab Di-sord. 1997;21(12):1104-10.
  • 20. Corbi GM, Carbone S, Ziccardi P, Giugliano G, Marfella R, Nappo F, et al. FFAs and QT intervals in obese women with visceral adiposity: effects of sustained weight loss over 1 year. J Clin Endocrinol Metab. 2002;87(5):2080-3.
  • 21. Girola A, Enrini R, Garbetta F, Tufano A, Caviezel F. QT dispersion in uncomplicated human obesity. Obes Res. 2001;9(2):71-7.
  • 22. Gryglewska B, Grodzicki T, Czarnecka D, Kawecka-Jaszcz K, Kocemba J. QT dispersion and hypertensive heart dise-ase in the elderly. J Hypertens. 2000;18(4):461-4.
  • 23. Karason K, Wallentin I, Larsson B, Sjöström L. Effects of obesity and weight loss on cardiac function and valvular performance. Obes Res. 1998;6(6):422-9.
  • 24. Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321(4):225-36.
  • 25. Chauhan VS, Krahn AD, Walker BD, Klein GJ, Skanes AC, Yee R. Sex differences in QTc interval and QT dispersion: dynamics during exercise and recovery in healthy sub-jects. Am Heart J. 2002;144(5):858-64.
  • 26. Di Salvo G, Pacileo G, Del Giudice EM, Natale F, Limon-gelli G, Verrengia M, et al. Atrial myocardial deformation properties in obese nonhypertensive children. J Am Soc Echocardiogr. 2008;21(2):151-6.
  • 27. Magnani JW, Lopez FL, Soliman EZ, Maclehose RF, Crow RS, Alonso A. P wave indices, obesity, and the metabolic syndrome: the atherosclerosis risk in communities study. Obesity (Silver Spring). 2012;20(3):666-72.
  • 28. Després JP. Body fat distribution and risk of cardiovascu-lar disease: an update. Circulation. 2012;126(10):1301-13.
  • 29. Robyns T, Lu HR, Gallacher DJ, Garweg C, Ector J, Wil-lems R, et al. Evaluation of Index of Cardio-Electrophysiological Balance (iCEB) as a New Biomarker for the Identification of Patients at Increased Arrhythmic Risk. Ann Noninvasive Electrocardiol. 2016;21(3):294-304.
  • 30. Ortega FB, Lavie CJ, Blair SN. Obesity and Cardiovascular Disease. Circ Res. 2016;118(11):1752-70.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kardiyoloji
Bölüm Araştırma Makalesi
Yazarlar

Serdar Söner 0000-0002-2807-6424

Metin Okşul 0000-0002-4759-4868

Tuncay Güzel 0000-0001-8470-1928

Adnan Duha Cömert 0000-0002-5924-4857

Ercan Taştan 0000-0002-4896-6993

Ahmet Taş 0000-0002-1275-7540

Erkan Baysal 0009-0002-2198-3459

Hülya Tosun Söner 0000-0003-1524-8685

Gamze Yeter Arslan 0000-0002-0114-7448

Erken Görünüm Tarihi 18 Ekim 2024
Yayımlanma Tarihi
Gönderilme Tarihi 9 Nisan 2024
Kabul Tarihi 3 Ekim 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 21 Sayı: 3

Kaynak Göster

Vancouver Söner S, Okşul M, Güzel T, Cömert AD, Taştan E, Taş A, Baysal E, Tosun Söner H, Arslan GY. The Relationship Between Body Mass Index And Index of Cardiac Electrophisiological Balance. Harran Üniversitesi Tıp Fakültesi Dergisi. 2024;21(3):375-81.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty